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February 14, 2005

Health Center Physicians Help
At Hospital Hit by Tsunami

Dr. Rob Fuller examines a patient with pneumonia caused by almost drowning.
Dr. Rob Fuller examines a patient with pneumonia caused by almost drowning, at the hospital in Banda Aceh, Indonesia. Also pictured are Dr. Scott Ferris, International Medical Corps physician, and Warda, a translator.

Photo supplied by Dr. Rob Fuller

Two emergency physicians from the Health Center returned recently from a three-week working trip to Banda Aceh, Indonesia, one of the areas worst hit by the Dec. 26 tsunami.

Dr. Rob Fuller, head of the Health Center’s Emergency Department, was in charge of the emergency department at Banda Aceh hospital, while Dr. Matthew Howell, an emergency room physician, traveled by boat to remote regions outside Banda Aceh to help out, including providing immunizations to survivors. They were part of a group organized by the International Medical Corps (IMC).

The conditions that awaited them when they arrived were severe. The once-thriving hospital had been devastated, and lacked personnel, equipment, and medication.

“The hospital used to be the pearl of Indonesia – one floor, no elevators, a staff of more than 400, and a couple of miles inland,” said Fuller. “After the tsunami, the mud was about four feet up the walls. Only 63 of the staff were accounted for – most were killed. Not one of the 17 doctors who had staffed the emergency room returned.”

On Fuller’s first day at what remained of the Banda Aceh hospital, he was asked by the temporary emergency room physician, “Are you here to be a tourist, or are you here to work?” Fuller replied, “To work,” and the doctor, who was scheduled to leave the next day, handed over his responsibilities to him. As the new leader of the emergency department, Fuller asked the same question often, as new volunteers showed up.

Fuller coordinated doctors from Spain, Pakistan, China, Korea, Belgium, and other countries in the emergency department. Other doctors, both from around Indonesia and from other countries, who came to help at the hospital were put in charge of their particular specialty areas.

They faced many challenges, including how to get oxygen, how to stop sewage leaks, and where to find the right drugs, many of which were labeled in foreign languages.

Fuller said he saw patients with diseases doctors in the West don’t normally see, such as tetanus, advanced TB, dengue virus, untreated gangrene, and pneumonia from near drowning.

And the conditions were trying: “You don’t eat, the temperature’s 110 degrees, there’s no water, the drugs are wrong, there’s no space – it went on and on,” he said.

One local doctor, who led the coordination of the hospital, had lost his son and his home, but still held a meeting every morning, with representatives from each nation reporting. Fuller was the spokesperson for the Americans, who were in charge of emergency medical care.

Meanwhile, Howell volunteered to travel by boat to remote regions outside Banda Aceh to help move supplies, erect tents, remove debris, and help in medical situations. The IMC was the first organization to reach these communities. Although the conditions were tough, the experience was rewarding, as thousands of people were immunized from the newly created facility.

Fuller’s wife, Natalie Coleman Fuller, shared some of the UConn physicians’ experiences in an e-mail to their colleagues.

“Rob and Matt are both healthy, 10 pounds lighter and running on adrenaline,” she wrote.

Coleman Fuller said that, difficult as the circumstances were, the two were well suited to join the relief effort. “Neither Matt nor Rob could have ignored the calling to this crisis,” she said. “Each has spent much of their lives preparing themselves for this type of situation. Both of them are strong, have common sense, have experience with construction, and have spent significant time practicing tropical medicine. Matt is bilingual, has traveled in many countries, and has first-hand knowledge of different cultures and customs. Rob has significant experience with tactical medicine, disaster medicine, and organizational skills. His last response to a large crisis was bringing a team to ground zero on September 11th, 2001.”

Some volunteers found the situation overwhelming, Coleman Fuller said, and many of them returned home after a few days.

Fuller and Howell were well prepared, however. “It seems the rope and duct tape Rob and Matt packed was put to good use for constructing their housing,” she said.

On his last day of work, Fuller turned the emergency department over to a Swiss physician. His contribution was acknowledged with a round of applause.

Fuller said the experience was one he could never forget. “This was the most incredible experience I’ve ever had,” he said, “personally, emotionally, professionally, and spiritually.”